Nasojugal crease, tear trough deformity, nasojugal groove, bags under eyes, under eye hollowness

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In the young individual the transition between lower eyelid and cheek is imperceptible. The dividing line between these areas in older individuals is the nasojugal crease also called the nasojugal groove (term first used in 1961) or tear trough (term first used in 1969). It is an early sign of aging around the eyes, lending a fatigued and aged appearance to the face. As part of the aging process ligaments that fix facial skin to the underlying facial bones thin and lengthen or stretch, facial bones recede back and facial fat shrinks. This results in the drooping of facial skin and appearance of laugh lines, jowls, nasojugal creases, eyelid bags etc.. The skin within the nasojugal groove or crease becomes thinner and/or darker in color than the slightly lower nose or cheek skin. It can also seem deeper or be more visible if there is protrusion of fat into the lower eyelid. The aging process starts near the nose as the tear trough and progresses outwardly towards the same side ear becoming what is called the palpebromalar groove.


Tear Trough and Palpebromalar Groove Boundaries



Examples of Tear Troughs in Younger Patients Without Protruding Eyelid Fat

Gynecomastia

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Gynecomastia means enlargement of the male breast. The definition has nothing to do with what causes the enlargement or what tissue it is composed of. It is most common around puberty & can involve one or both sides of the chest. Most commonly the enlargement is centralized in the breast but occasionally it is not. It is present to some degree in about a third of male population. It appears either early in adolescence or later in the adult years of life and can be very disruptive in the life of a teenager or adult. Working out in the gym, going to the beach and changing in the locker room can become unpleasant ordeals.